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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE. ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />PROJECT ADDRESS <br />2iN !�U1,-t St4 0-0-00 //(n 1'1"- ST. nf- �V E, 7 - IA-'P- <br />Owner Mall Address City Stale/Zip Phone <br />Tenant Mail Address Clly State/Zip Phone <br />/ /SENdW 5U th <br />WA d�- Z-Dr) 33 <br />Electrical Contractor Mail Address City State/Zip Phone <br />Pl Al Al A-E l q 2-¢ V_N 2_4 o0 <br />State License Number / Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: _()(% k: D <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not resume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authonzed by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />c <br />ignature Ubte <br />I <br />', j'05 v9-0 f i <br />